Disabled activists often claim that there are two models of disability―the medical and the social model. Put briefly, the medical model sees a disabled person, sees that they can’t always function as a member of society, and wonders how to change the disabled person―how to hide the disability and normalise them. The social model sees a disabled person not functioning in society, and wonders how to change society- how to best cater for the person with the disability.

I’ve been thinking recently about the effect of the medical and social models when it comes to sex. It seems to me that there are two ways to view any sexual ‘dysfunctions’ (oh gods, we really need a neutral term). To take a simple example, ‘premature’ ejaculation (more neutral terms please) amongst male-bodied people. Over the years, I’ve seen various sexologists and advice columns touting ‘cures’ for this, sometimes in ludicrous hyperbole that actually feeds into the problem (‘keep going for hours’). This is a medical model―someone isn’t functioning the same way as other people, we have to fix them.

Then there’s the advice, ‘adjust your expectations, realise that you’re probably normal, what you see in porn isn’t accurate,’ etc. This sounds a lot like the beginnings of a social model―the problem isn’t physiological, it’s you and your partners’ issues with your physiology. But this isn’t a fully sociological model. This approach still fundamentally says that there’s a problem―that there’s some minimum time before which you’re premature, it’s just lower than you think. It’s ‘no, you’re not fat (but QED some people are, and it’s something to be ashamed of)’ rather than ‘Fuck ‘em, you’re you, and you’re gorgeous, and you’re amazing.’

Which brings me to why I would be a terrible advice columnist. Because whenever I hear a complaint like this, I just think ‘Ok, what’s the problem?’ I blame years of asexual indoctrination, but I’m now so firmly stuck in the social model that I can barely even acknowledge or comprehend the medical model. My advice to a ‘premature’ man would probably involve the word ‘phallocentric’ and a link to Greta Christina. I am completely, almost irrationally, wedded to the idea that you come to sex being who you are and then find ways to make that work. Having fought so hard for an asexual identity when the medical model tells me I have to fix myself, not accept myself, I have now rejected the medical model entirely.

And I love reading sex advice columns with the distinction between medical and social models in mind, because it gives a great insight into what the hell is going on. The problem is that the medical and social models give advice that is inherently contradictory, so you get letters from women who can’t orgasm with responses like: ‘Well, 70% of women can’t orgasm from coital sex alone, and that’s ok, but have you tried scheduling sex, and maybe don’t do it at night, when you’re tired, and maybe try ____ sex, and maybe make sure you’re confident in your body and make sure you’re eating right and are you sure you’re still in love with your partner, and maybe try the new trick on page 23???’ It’s a similar response that is sometimes expected from us when someone asks ‘Am I asexual?’; ‘Well, if you’re asexual, that’s fine, but have you considered that maybe you’ve not met the right person or you need your hormones checked or you don’t have crippling body issues, or are dealing with trauma from past abuse or, or, or????’

And sometimes it makes me feel bad that I lean to such an extreme social model. Because some people probably would benefit from the new trick on page 23. Because change, and growth, and getting better are part of life. People probably end up having more pleasing sex if they see it as a skill set they can improve and faults that they can address, like remembering to point your toes during your plie, rather than something akin to a sexual orientation, where someone is oppressing you if they ask you to consider changing it. The question is what, ultimately, is a part of you, and what is just a thing you do? Is premature ejaculation or anorgasmia or any of the other thousands of variations in sexual behaviour an identity you can claim, a facet of yourself that you can work with, that can take you down interesting roads you never dreamt of, or is it a flaw in technique that can, and should, be countered, a problem with a simple answer that could make you happy?

And where does asexuality fit in all this? Because, like it or not, it does fit. I’d like to say that I’m proud of the general queerifying effect asexuality has. Asexuality, properly understood, defies the very idea of the ‘normal’―there are so many shades of being sexual, there are so many different attractions to feel, there are so many orientations, and conceptual distinctions, and you could say that the asexual movement has embraced the social model of sexuality―you are who you are, and that’s fine. But that just presses this distinction―which of the things you do or don’t do in the bedroom are things you are, and which are just things you do? And how can we ever hope to draw that line?

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About Siggy

Siggy is a physics grad student in the U.S. He is gay gray-A, and makes amateur attempts at asexual activism. His interests include godlessness, scientific skepticism, and math. While not working or blogging, he plays video and board games with his boyfriend, and folds colored squares.

4 Responses to Sexual ‘dysfunction’ and social models of disability

This is really really interesting and yet at the same time it’s really difficult to be sure about what your main point is.
Is it : because asexuality was (and still is) considered a “sexual dysfunction”, but is now considered a sexual orientation, then all “sexual dysfunctions” should be examined to see if it wouldn’t be beneficial to frame them in terms of identity, as a part of ourselves rather than a disorder.
Or is it : Because asexuality was (and stil is) considered a “sexual dysfunctions”, and because the other “sexual dysfunctions” are clearly not a part of one’s identity, we should reflect on how and why we do think that asexuality is a part of our identity ?
Or is it : What kind of criteria, if any, can we find to make the difference between what is part of one’s identity and what is not ?

All of them? I didn’t start to write this to persuade anyone of anything, I just had some ideas about the social and medical models as they relate to sex, and I felt like these ideas connected to asexuality somehow. I didn’t really have a point, it was more of a dialogue-starter. I guess the point is that the difference between an identity and an affliction is *entirely* conceptual, so the rigid distinction we draw between how we treat the two is an abstraction, which has relevance to asexuality and to sexual ‘disorders’?